WO2013010100A1 - Procédés pour le traitement de l'incontinence associée à l'activité sexuelle - Google Patents

Procédés pour le traitement de l'incontinence associée à l'activité sexuelle Download PDF

Info

Publication number
WO2013010100A1
WO2013010100A1 PCT/US2012/046720 US2012046720W WO2013010100A1 WO 2013010100 A1 WO2013010100 A1 WO 2013010100A1 US 2012046720 W US2012046720 W US 2012046720W WO 2013010100 A1 WO2013010100 A1 WO 2013010100A1
Authority
WO
WIPO (PCT)
Prior art keywords
botulinum toxin
incontinence
patient
sexual activity
botulinum
Prior art date
Application number
PCT/US2012/046720
Other languages
English (en)
Inventor
Mitchell F. Brin
Original Assignee
Allergan, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Allergan, Inc. filed Critical Allergan, Inc.
Priority to EP12738350.3A priority Critical patent/EP2731620A1/fr
Priority to CA2841917A priority patent/CA2841917A1/fr
Priority to RU2014103542/15A priority patent/RU2578475C2/ru
Priority to JP2014520379A priority patent/JP6092205B2/ja
Priority to KR1020147003752A priority patent/KR20140054055A/ko
Priority to CN201280042815.5A priority patent/CN103813802A/zh
Priority to AU2012280947A priority patent/AU2012280947B2/en
Priority to BR112014000634A priority patent/BR112014000634A2/pt
Publication of WO2013010100A1 publication Critical patent/WO2013010100A1/fr
Priority to IN253DEN2014 priority patent/IN2014DN00253A/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/4886—Metalloendopeptidases (3.4.24), e.g. collagenase
    • A61K38/4893—Botulinum neurotoxin (3.4.24.69)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0034—Urogenital system, e.g. vagina, uterus, cervix, penis, scrotum, urethra, bladder; Personal lubricants
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/08—Solutions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P13/00—Drugs for disorders of the urinary system
    • A61P13/10—Drugs for disorders of the urinary system of the bladder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Y—ENZYMES
    • C12Y304/00—Hydrolases acting on peptide bonds, i.e. peptidases (3.4)
    • C12Y304/24—Metalloendopeptidases (3.4.24)
    • C12Y304/24069—Bontoxilysin (3.4.24.69), i.e. botulinum neurotoxin
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

  • the present invention relates to methods for treating incontinence using botulinum toxins and other treatments.
  • Incontinence associated with sexual activity encompasses several forms, including orgasm-associated incontinence and climacturia, and can involve incontinence at different points along the sexual spectrum, for example, at penetration, during intercourse, or at climax.
  • the condition can be associated with disorders including overactive bladder (OAB) and neurogenic detrussor overactivity (NDO), and has received increasing attention in the medical literature. Additionally, it can significantly impact sexual satisfaction among both sufferers (both men and women) and their partners.
  • Some male sufferers develop incontinence associated with sexual activity following prostate surgery such as radical prostatectomy (RP; removal of the prostate) or brachytherapy.
  • Prostate cancer is the second most commonly diagnosed cancer in males in the United States, accounting for approximately 33% of new cancer cases, and is the third leading cause of cancer-related death in men.
  • RP Several surgery-related complications are associated with RP, including urinary incontinence and sexual dysfunction.
  • the nature and degree of sexual dysfunction can vary widely following RP, including erectile dysfunction, loss of libido, orgasm alterations (anorgasmia, decreased orgasmic intensity, dysorgasmia and orgasm-associated incontinence) and decreased sexual satisfaction.
  • Abouassaly and coworkers (Abouassaly R, Lane B. Lakin M, Klein E, Gill I.
  • Men can also display a form of stress incontinence after RP wherein incontinence can occer during intercourse and continue through climax.
  • incontinence associated with sexual activity may be associated with detrusor overactivity linked to overactive bladder (OAB), or to neurogenic detrussor overactivity (NDO)- one study has found that orgasm can produce an uninhibited detrusor contraction. It has also been associated with female ejaculation in the absence of OAB (Cartwright, 2007) or other urodynamic abnormality. Additionally, some researchers speculate that incontinence associated with sexual activity can be linked with stress or sphincter incontinence. This incontinence can, as in the case with males, occur at any point from before penetration to after climax.
  • OAB overactive bladder
  • NDO neurogenic detrussor overactivity
  • Coital Incontinence is urinary leakage that occurs during either penetration or orgasm and can occur with a sexual partner or with masturbation. It has been reported to occur in 10% to 24% of sexually active women with pelvic floor disorders, yet CI may still be an underreported problem since sexual or urinary dysfunction may not be often or readily discussed due to patient or physician embarrassment.
  • CI can have a disturbing impact on Quality of Life (QoL) and sexuality. Women rarely refer to it spontaneously, with only 3% of women self-reporting sexual disorders including CI; even with direct questioning, only 20% will admit to it. The impact on QoL from CI is significant. Sexually active women with CI reported a worse QoL than those without it.
  • Coital incontinence is divided into 2 subtypes based on when urinary leakage occurs: incontinence with penetration and incontinence with orgasm. Each has different pathophysiologic causes.
  • incontinence with penetration was strongly correlated to stress urinary incontinence
  • Ci from orgasm was strongly correlated with detrusor overactivity.
  • a larger, more recent series of 132 women confirms the findings that the majority of women, 63%, experience CI from penetration, while 37% do so from orgasm.
  • Botulinum toxin type A is the most lethal natural biological agent known to man. About 50 picograms of botulinum toxin type A (available from Allergan, Inc., of Irvine, Calif, under the tradename BOTOX ® ) is an LD 50 in mice. One unit (U) of botulinum toxin is defined as the LD 50 upon intraperitoneal injection into female Swiss Webster mice weighing 18- 20 grams each. Seven immunologically distinct botulinum neurotoxins have been characterized, these being respectively botulinum neurotoxin serotypes A, B, C ls D, E, F and G, each of which is distinguished by neutralization with type-specific antibodies.
  • botulinum toxin vary in the animal species that they affect and in the severity and duration of the paralysis they evoke.
  • the botulinum toxins apparently bind with high affinity to cholinergic motor neurons, are translocated into the neuron and block the release of acetylcholine.
  • Botulinum toxins have been used in clinical settings for the treatment of neuromuscular disorders characterized by hyperactive skeletal muscles.
  • Botulinum toxin type A has been approved by the U.S. Food and Drug Administration for the treatment of blepharospasm, strabismus, hemifacial spasm, cervical dystonia, and migraine headaches.
  • Botulinum toxin type B has also been approved by the FDA for the treatment of cervical dystonia.
  • Clinical effects of peripheral intramuscular botulinum toxin type A are usually seen within one week of injection. The typical duration of symptomatic relief from a single intramuscular injection of botulinum toxin type A averages about three months.
  • botulinum toxin type A has been used in clinical settings as follows:
  • BOTOX ® 5-10 U of BOTOX ® per intramuscular injection to treat glabellar lines (brow furrows) (5 U injected intramuscularly into the procerus muscle and 10 U injected intramuscularly into each corrugator supercilii muscle); [0014] about 30-80 U of BOTOX ® to treat constipation by intrasphincter injection of the puborectalis muscle;
  • extraocular muscles have been injected intramuscularly with between about 1-5 U of BOTOX ® , the amount injected varying based upon both the size of the muscle to be injected and the extent of muscle paralysis desired (i.e. the amount of diopter correction desired).
  • Each of the five indicated muscles has been injected at the same treatment session, so that the patient receives from 90 U to 360 U of upper limb flexor muscle BOTOX ® by intramuscular injection at each treatment session.
  • BOTOX ® To treat migraine, pericranial (symmetrically into glabellar, frontalis and temporalis muscles) injection of BOTOX ® has showed significant benefit as a prophylactic treatment compared to vehicle as measured by decreased measures of migraine frequency, maximal severity, associated vomiting and acute medication use over the three month period following the 25 U injection.
  • botulinum toxins may also have inhibitory effects in the central nervous system.
  • Work by Weigand et al., Naunyn-Schmiedeberg's Arch. Pharmacol. 1976; 292, 161-165, and Habermann, Naunyn-Schmiedeberg's Arch. Pharmacol. 1974; 281, 47-56 showed that botulinum toxin is able to ascend to the spinal area by retrograde transport.
  • a Botulinum toxin has also been proposed for the treatment of rhinorrhea, hyperhydrosis and other disorders mediated by the autonomic nervous system (U.S. Pat. No. 5,766,605), tension headache, (U.S. Pat. No. 6,458,365), migraine headache (U.S. Pat. No. 5,714,468), post-operative pain and visceral pain (U.S. Pat. No. 6,464,986), pain treatment by intraspinal toxin administration (U.S. Pat. No. 6,113,915), Parkinson's disease and other diseases with a motor disorder component, by intracranial toxin administration (U.S. Pat. No. 6,306,403), hair growth and hair retention (U.S. Pat.
  • Adrenergic nerves release norepinephrine as the neurotransmitter for the sympathetic nervous system.
  • the sympathetic system activates and prepares the body for vigorous muscular activity, stress, and emergencies.
  • Adrenergic drugs stimulate the adrenergic nerves directly by mimicking the action of norepinephrine or indirectly by stimulating the release of norepinephrine.
  • An adrenergic agent is a drug, or other substance, which has effects similar to, or the same as, epinephrine (adrenaline). Thus, it is a kind of sympathomimetic agent. Alternatively, it may refer to something which is susceptible to epinephrine, or similar substances, such as a biological receptor (specifically, the adrenergic receptors).
  • Adreneric agonists stimulate a response from the adrenergic receptors.
  • the five categories of adrenergic receptors are: a ls a 2 , ⁇ , ⁇ 2 , and ⁇ 3 , and agonists vary in specificity between these receptors, and may be classified respectively.
  • Epinephrine and norepinephrine are endogenous and broad- spectrum. More selective agonists are more useful in pharmacology.
  • a great number of drugs are available which can affect adrenergic receptors. Each drug has its own receptor specificity giving it a unique pharmacological effect. Other drugs affect the uptake and storage mechanisms of adrenergic catecholamines, prolonging their action.
  • Agents that work with and activate the adrenergic receptors include alpha- and beta-adrenergic agonists.
  • Agents that increase neurotransmission in endogenous chemicals such as epinephrine and norepinephrine include amphetamines, cocaine, methylenedioxymethamphetamine (MDMA), tyramine, nicotine, caffeine, and methylphenidate. Agents that exhibit aspects of both of these modes include ephedrine and pseudoephedrine.
  • Embodiments of the invention include methods of treating incontinence, including urinary incontinence, associated with sexual activity using a botulinum toxin.
  • the incontinence treatment can comprise treatment of females with climacturia who also have detrusor overactivity, such as, for example, OAB, or NDO, or the like.
  • the OAB or NDO can be state-dependent, i.e. onlypresent at, for example, penetration, or orgasm, or the like.
  • the incontinence treatment can comprise treatment of females with climacturia who also have stress incontinence.
  • the incontinence treatment can comprise treatment of females with climacturia who do not also have demonstrated bladder or outlet disorders. In certain embodiments the incontinence treatment can comprise treatment of males who do not also have demonstrated bladder or outlet disorders. In embodiments the incontinence can occur before, during, or after orgasm. In embodiments the incontinence can occur before, during, or after penetration. In embodiments, the botulinum toxin is administered to, for example, the bladder, or the like. In embodiments the toxin is administered, for example, via injection, or transdermally, or via instillation, or the like.
  • Embodiments include a method of treating post-surgical incontinence associated with sexual activity comprising administering a therapeutically effective amount of a botulinum toxin to a patient in need thereof, thereby treating the incontinence associated with sexual activity.
  • the incontinence associated with sexual activity occurs following a surgical procedure, such as, for example, for a prostate disorder.
  • the surgical procedure is selected from the group consisting of radical prostatectomy, laparoscopic radical prostatectomy, transurethral resection of the prostate, transurethral microwave therapy, transurethral needle ablation, and cryosurgery.
  • the botulinum toxin is administered to, for example, the prostate, the bladder, or a combination thereof, or the like.
  • the toxin is administered, for example, via injection, or transdermally, or via instillation, such as into the bladder, or the like.
  • the incontinence can occur before, during, or after orgasm. In embodiments the incontinence can occur before, during, or after penetration
  • Embodiments include a method of preventing post-surgical incontinence associated with sexual activity comprising administering a therapeutically effective amount of a botulinum toxin to a patient in need thereof, thereby preventing the incontinence associated with sexual activity.
  • the incontinence associated with sexual activity occurs following a surgical procedure, such as, for example, for a prostate disorder.
  • the surgical procedure is selected from the group consisting of radical prostatectomy, laparoscopic radical prostatectomy, transurethral resection of the prostate, transurethral microwave therapy, transurethral needle ablation, and cryosurgery.
  • the botulinum toxin is administered to, for example, the prostate, the bladder, or a combination thereof, or the like.
  • the toxin is administered, for example, via injection, or transdermally, or via instillation, such as into the bladder, or the like.
  • the patient is administered the botulinum toxin at a time selected from the group consisting of before surgery, during surgery, after surgery, and combinations thereof.
  • the incontinence can occur before, during, or after orgasm. In embodiments the incontinence can occur before, during, or after penetration.
  • the botulinum toxin is selected from the group consisting of types A, B, C, D, E, and, G.
  • Embodiments of the invention include methods of treating incontinence, including urinary incontinence, associated with sexual activity using a botulinum toxin in combination with, for example, a drug that has an effect on the tonicity of the bladder or sphincter muscle, such as the urinary sphincter.
  • the incontinence treatment can comprise treatment of females with climacturia who also have detrusor overactivity, such as, for example, OAB, or NDO, or the like.
  • the OAB or NDO can be state-dependent, i.e. onlypresent at, for example, penetration, or orgasm, or the like.
  • the incontinence treatment can comprise treatment of females with climacturia who also have stress incontinence. In certain embodiments the incontinence treatment can comprise treatment of females with climacturia who do not also have demonstrated bladder or outlet disorders. In certain embodiments the incontinence treatment can comprise treatment of males who do not also have demonstrated bladder or outlet disorders. In embodiments the incontinence can occur before, during, or after orgasm. In embodiments the incontinence can occur before, during, or after penetration. In embodiments, the botulinum toxin in combination with a drug that has an effect on the tonicity of a the sphincter muscle is administered to, for example, the bladder, or the like. In embodiments the toxin is administered, for example, via injection, or transdermally, or via instillation, or the like.
  • Embodiments of the invention include methods of treating incontinence, including urinary incontinence, associated with sexual activity using a drug that has an effect on the tonicity of the bladder or sphincter muscle, such as the urinary sphincter.
  • the incontinence treatment can comprise treatment of females with climacturia who also have detrusor overactivity, such as, for example, OAB, or NDO, or the like.
  • the OAB or NDO can be state-dependent, i.e. onlypresent at, for example, penetration, or orgasm, or the like.
  • the incontinence treatment can comprise treatment of females with climacturia who also have stress incontinence.
  • the incontinence treatment can comprise treatment of females with climacturia who do not also have demonstrated bladder or outlet disorders. In certain embodiments the incontinence treatment can comprise treatment of males who do not also have demonstrated bladder or outlet disorders. In embodiments the incontinence can occur before, during, or after orgasm. In embodiments the incontinence can occur before, during, or after penetration. In embodiments, the botulinum toxin in combination with a drug that has an effect on the tonicity of a the sphincter muscle is administered to, for example, the bladder, or the like. In embodiments the toxin is administered, for example, via injection, or transdermally, or via instillation, or the like.
  • the drug that has an effect on the tonicity of the sphincter muscle can be, for example, an anticholinergic, or an andergenic, such as an alpha- or beta- adrenergic agonist, or amphetamines, cocaine, methylenedioxymethamphetamine (MDMA), tyramine, nicotine, caffeine, and methylphenidate.
  • the drug that has an effect on the tonicity of the bladder or sphincter muscle can be any drug that relaxes smooth muscles in the gastrointestinal tract, or relaxes bladder muscles, or increases contraction of the bladder sphincter.
  • SUDAFED ® contains the active ingredient pseudoephedrine and refers to a family of over the counter (OTC) decongestants manufactured by McNeil Laboratories (a division of Johnson & Johnson) for sale in Australia, New Zealand, Canada, Ireland, South Africa, the United Kingdom, and the United States.
  • OTC over the counter
  • the drug exhibits an anticholinergic effect and thus is suitable for use in embodiments of the invention.
  • Other anticholinergics suitable for use in embodiments of the invention include oxybutynin (Ditropan), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium (Sanctura).
  • Other drugs that can be used in embodiments of the present invention include Imipramine and Duloxetine.
  • the present invention meets this need and provides for improved methods for treating incontinence associated with sexual activity.
  • the methods comprise the step of locally administering a neurotoxin (e.g., a botulinum toxin type A and/or other types) to at least one anatomical site.
  • a neurotoxin e.g., a botulinum toxin type A and/or other types
  • the dose of neurotoxin to be administered is equivalent to about 1 U to about 500 U of a botulinum toxin type A.
  • the method of administration can be systemic, such as, for example, intravenously, or local, such as, for example, via injection into the prostate or bladder or a combination thereof, by implant, with a topical formulation, via instillation, or the like.
  • the invention comprises a method of treating incontinence associated with sexual activity in patients who also have detrusor overactivity, such as, for example, OAB, or NDO, or the like, comprising administering an effective amount of a botulinum toxin composition to the surface or within the tissue of a patient in need thereof.
  • a botulinum toxin composition comprises botulinum toxin encapsulated in phospholipid micelles, and / or one or more primary stabilizers, and / or one or more skin penetration enhancers.
  • 50U, or 75U, or 100U, or 150U, or 200U, or 300U, or 400U of botulinum toxin type A is instilled into the bladder of a patient suffering from incontinence associated with sexual activity wherein the patient also suffers from detrusor overactivity.
  • 50U, or 75U, or 100U, or 150U, or 200U, or 300U, or 400U of botulinum toxin type A is injected into the bladder of a patient suffering from incontinence associated with sexual activity wherein the patient also suffers from detrusor overactivity.
  • the invention comprises a method of treating post-surgical incontinence associated with sexual activity, such as, for example, following RP, comprising administering an effective amount of a botulinum toxin composition to the surface or within the tissue of a patient in need thereof.
  • the botulinum toxin composition comprises botulinum toxin encapsulated in phospholipid micelles, and / or one or more primary stabilizers, and / or one or more skin penetration enhancers.
  • such treatment can comprise administration of a botulinum to toxin to the prostate via, for example, injection, topical admistration, or the like.
  • the invention comprises a method of preventing post-surgical incontinence associated with sexual activity, such as, for example, following RP, comprising administering an effective amount of a botulinum toxin composition to the surface or within the tissue of a patient in need thereof.
  • the botulinum toxin composition comprises botulinum toxin encapsulated in phospholipid micelles, and / or one or more primary stabilizers, and / or one or more skin penetration enhancers.
  • such treatment can comprise administration of a botulinum to toxin to the prostate via, for example, injection, topical admistration, or the like.
  • alleviating means a reduction in or prevention of the occurrence of a symptom related to incontinence associated with sexual activty.
  • alleviating includes some reduction, significant reduction, near total reduction, and total reduction of a symptom related to incontinence associated with sexual activty.
  • An alleviating effect may not appear clinically for between 1 and 7 days after administration of a botulinum toxin to a patient.
  • Botulinum toxin means a botulinum neurotoxin as either pure toxin (i.e. about 150 kDa weight molecule) or as a complex (i.e. about 300 to about 900 kDa weight complex comprising a neurotoxin molecule and one or more associated non-toxic molecules), and excludes botulinum toxins which are not neurotoxins such as the cytotoxic botulinum toxins C2 and C3, but includes recombinantly made, hybrid, modified, and chimeric botulinum toxins.
  • Drug that has an effect on the tonicity of the bladder or sphincter muscle means any drug, compound, or molecule that can affect the muscle tension of the bladder or a sphincter muscle, such as the urinary sphincter.
  • Effective amount as applied to the neurotoxin means that amount of the neurotoxin generally sufficient to effect a desired change in the subject.
  • the neurotoxin can be administered in an amount between about 0.01 U/kg and about 35 U/kg and the symptoms of the condition can be substantially alleviated for between about 1 month and about 27 months, for example for from about 1 month to about 6 months.
  • Improved patient function means an improvement measured by factors such as reduced pain, reduced time spent in bed, reduced urination upon climax, increased ambulation, healthier attitude, more varied lifestyle and/or healing permitted by normal muscle tone. Improved patient function is synonymous with an improved quality of life (QoL).
  • QoL can be assessed using, for example, the known SF-12 or SF-36 health survey scoring procedures.
  • SF-36 assesses a patient's physical and mental health in the eight domains of physical functioning, role limitations due to physical problems, social functioning, bodily pain, general mental health, role limitations due to emotional problems, vitality, and general health perceptions. Scores obtained can be compared to published values available for various general and patient populations.
  • Incontinence means the unintended release of bodily fluid, not limited to urine.
  • Incontinence associated with sexual activity means the unintended release of bodily fluid, not limited to urine, during sexual activity.
  • Local administration means direct administration to a location, such as, for example, by injection, instillation, implant, or topical application, such as, for example, using microemulsion creams or topical compositions. Local administration excludes systemic routes of administration, such as intravenous or oral administration.
  • “Sexual activity” means any act relating to sex, including, for example, foreplay, penetration, intercourse, oral sex, etc.
  • Treating means to alleviate (or to eliminate) at least one symptom related to climacturia, such as incontinence, either temporarily or permanently.
  • Urogenic abnormality means any condition causing a urologic effect, such as OAB, NDO, stress incontinence, sphincter incontinence, etc.
  • compositions contemplated by this invention include pharmaceutical compositions suited for topical and local action.
  • topical as employed herein relates to the use of a composition, as described herein, incorporated in a suitable pharmaceutical carrier.
  • topical compositions include those pharmaceutical forms in which the compound is applied externally by direct contact with the skin surface to be treated.
  • Conventional pharmaceutical forms for this purpose include ointments, liniments, creams, shampoos, lotions, pastes, jellies, sprays, aerosols, and the like, and can be applied in patches or impregnated dressings depending on the part of the body to be treated.
  • composition embraces formulations (including creams) having oleaginous, water-soluble and emulsion-type bases, e.g., petrolatum, lanolin, polyethylene glycols, as well as mixtures of these.
  • topical as employed herein relates to the use of a composition suitable for instillation, a procedure in which a fluid is introduced into a cavity or passage of the body and allowed to remain for a specific length of time before being drained or withdrawn. It is performed to expose the tissues of the area to the solution, to warmth or cold, or to a drug or substance in the solution.
  • the composition can be warmed or cooled prior to instillation.
  • compositions of the invention can be applied applied a single time or repeatedly at regular or non-regular intervals for a sustained period of time.
  • compositions of the invention can be administered topically to the part of the body to be treated.
  • compositions of the invention can be administered systemically, such as, for example, intravenously.
  • compositions can be formulated in aqueous solutions, creams, ointments or oils exhibiting physiologically acceptable osmolarity by addition of pharmacologically acceptable buffers and salts.
  • Such formulations may or may not, depending on the dispenser, contain preservatives such as benzalkonium chloride, chlorhexidine, chlorobutanol, parahydroxybenzoic acids and phenylmercuric salts such as nitrate, chloride, acetate, and borate, or antioxidants, as well as additives like EDTA, sorbitol, boric acid etc. as additives.
  • aqueous solutions may contain viscosity increasing agents such as polysaccharides, e.g., methylcellulose, mucopolysaccharides, e.g., hyaluronic acid and chondroitin sulfate, or polyalcohol, e.g., polyvinylalcohol.
  • viscosity increasing agents such as polysaccharides, e.g., methylcellulose, mucopolysaccharides, e.g., hyaluronic acid and chondroitin sulfate
  • polyalcohol e.g., polyvinylalcohol.
  • slow releasing gels and matrices may also be employed as well as soluble and insoluble ocular inserts, for instance, based on substances forming in-situ gels.
  • various amounts of the drug and different dose regimens may be employed.
  • the neurotoxins of the instant invention can be administered by any suitable means.
  • botulinum toxin is administered by injection.
  • Such injection can be administered to any affected area.
  • the neurotoxin can be injected urethroscopically into the prostate with, for example, 100 U with single or serial dosing, or 200 U with single or serial dosing, or 300 U with single or serial dosing, or 400 U with single or serial dosing, or the like.
  • the neurotoxin is injected every three weeks, or every four weeks, or every five weeks, or a lesser or greater interval, or the like until a therapeutic effect is achieved, or up to about 2500 U, or up to about 3000 U, or up to about 3500 U, or more, or the like.
  • Botulinum toxins for use according to the present invention can be stored in lyophilized, vacuum dried form in containers under vacuum pressure or as stable liquids. Prior to lyophilization the botulinum toxin can be combined with pharmaceutically acceptable excipients, stabilizers and/or carriers, such as albumin. The lyophilized material can be reconstituted with saline or water to create a solution or composition containing the botulinum toxin to be administered to the patient.
  • Exemplary, commercially available, botulinum toxin containing compositions include, but are not limited to, BOTOX ® (botulinum toxin type A neurotoxin complex with human serum albumin and sodium chloride) available from Allergan, Inc., of Irvine, Calif, in 100 U vials as a lyophilized powder to be reconstituted with 0.9% sodium chloride before use), DYSPORT ® (Clostridium botulinum type A toxin haemagglutinin complex with human serum albumin and lactose in the formulation, available from Ipsen Limited, Berkshire, U.K.
  • BOTOX ® botulinum toxin type A neurotoxin complex with human serum albumin and sodium chloride
  • DYSPORT ® Clostridium botulinum type A toxin haemagglutinin complex with human serum albumin and lactose in the formulation, available from Ipsen Limited, Berkshire, U.K.
  • BOTOX ® as a powder to be reconstituted with 0.9% sodium chloride before use
  • MYOBLOC ® an injectable solution comprising botulinum toxin type B, human serum albumin, sodium succinate, and sodium chloride at about pH 5.6, available from Solstice Neurosciences, Inc., South San Francisco, Calif.
  • BOTOX ® as set forth herein in each instance
  • MYOBLOC ® an injectable solution comprising botulinum toxin type B, human serum albumin, sodium succinate, and sodium chloride at about pH 5.6, available from Solstice Neurosciences, Inc., South San Francisco, Calif.
  • XEOMIN ® (a 150 kDa botulinum toxin type A formulation available from Merz Pharmaceuticals, Potsdam, Germany) is another useful neurotoxin which can be used at about 1 to about 2 times the amounts of BOTOX ® as set forth herein in each instance.
  • no less than about 10 U and no more about 400 U of BOTOX ® ; or no less than about 30 U and no more than about 1600 U of DYSPORT ® ; or no less than about 250 U and no more than about 20000 U of MYOBLOC ® are administered per site, per patent treatment session.
  • no less than about 20 U and no more than about 300 U of BOTOX ® ; or no less than about 60 U and no more than about 1200 U of DYSPORT ® ; or no less than about 1000 U and no more than about 15000 U of MYOBLOC ® are administered per site, per patent treatment session.
  • compositions may only contain a single type of botulinum toxin, such as, for example, type A, as the active ingredient
  • other therapeutic compositions may include two or more types of botulinum toxins.
  • a composition administered to a patient may include botulinum toxin type A and botulinum toxin type B, or the like. Administering a single composition containing two different neurotoxins can permit the effective concentration of each of the neurotoxins to be lower than if a single neurotoxin is administered to the patient while still achieving the desired therapeutic effects.
  • the composition administered to the patient may also contain other pharmaceutically active ingredients, such as, for example, protein receptor or ion channel modulators, or the like, in combination with the neurotoxin or neurotoxins.
  • compositions of the invention can comprise re-targeted endopeptidases; molecules derived by replacing the naturally-occurring binding domain of a clostridial toxin with a targeting domain showing a selective binding activity for a non- clostridial toxin receptor present in a cell of interest. Such modifications to the binding domain result in a molecule that is able to selectively bind to a non-clostridial toxin receptor present on the target cell.
  • a re-targeted endopeptidase can bind to a target receptor, translocate into the cytoplasm, and exert its proteolytic effect on the SNARE complex of the neuronal or non- neuronal target cell of interest.
  • the composition can comprise re-targeted endopeptidases.
  • Re -targeted endopeptidases can decrease the effects of sensory afferents, including conditions that are predominantly motor in origin. See, for example, U.S. Patent Ser. No. 7,658,933 to Foster et al., titled “Non-Cytoxtoxic Protein Conojugates”; U.S. Patent Ser. No. 7,659,092 to Foster et al., titled “Fusion Proteins”; and USSN 12/303,078 to Foster et al., titled “Treatment of Pain,” all incorporated entirely by reference.
  • endopeptidases can modulate pain associated with multiple medical conditions.
  • Certain embodiments of the invention can utilize a combination of re-targeted endopeptidases and botulinum toxins.
  • the combination of botulinum toxins and re-targeted endopeptidases allows for dose reduction of active agents (with associated reduction in side effects) as well as possible synergistic effects. Non-paralytic effects, and also possible prophylactic effects especially when used early in the condition can provide further benefits.
  • the molar ratio of botulinum toxin to re-targeted endopeptidases in the combination treatment can be, for example, a 1 : 1 ratio; a 1 :2 ratio; a 1 :5 ratio; a 1 : 10 ratio; a 1 :20 ratio; a 1 :50 ratio; a 1 : 100 ratio; 1 :200 ratio; a 1 :500 ratio; a 1 : 1000 ratio; 1 :2,000 ratio; a 1 :5,000 ratio; a 1 : 10,000 ratio, or the like.
  • the molar ratio of botulinum toxin to re-targeted endopeptidases in the combination treatment can be, for example, a 1 : 1 ratio; a 2: 1 ratio; a 5: 1 ratio; a 10: 1 ratio; a 20: 1 ratio; a 50: 1 ratio; a 100: 1 ratio; 200: 1 ratio; a 500: 1 ratio; a 1000: 1 ratio; 2000: 1 ratio; a 5000: 1 ratio; a 10,000: 1 ratio, or the like.
  • Implants useful in practicing the methods disclosed herein may be prepared by mixing a desired amount of a stabilized Botulinum toxin (such as non-reconstituted BOTOX ® ) or re-targeted endopeptidases into a solution of a suitable polymer dissolved in methylene chloride.
  • the solution can be prepared at room temperature.
  • the solution can then be transferred to a Petri dish and the methylene chloride evaporated in a vacuum desiccator.
  • a suitable amount of the dried neurotoxin-incorporating implant is compressed at about 8000 p.s.i.
  • Embodiments of the invention can also utilize botulinum toxins in powder form, and or administered via a needleless injection system, or the like.
  • administration of the composition can follow, accompany, or precede a surgical procedure, such as, for example, radical prostatectomy, laparoscopic radical prostatectomy, transurethral resection of the prostate, transurethral microwave therapy, transurethral needle ablation, cryosurgery, and the like.
  • a surgical procedure such as, for example, radical prostatectomy, laparoscopic radical prostatectomy, transurethral resection of the prostate, transurethral microwave therapy, transurethral needle ablation, cryosurgery, and the like.
  • a physician can alter dosage in each case in accordance with the assessment of the severity of the condition, as typically done when treating patients with a condition/disorder. Further, in some embodiments, the treatment may have to be repeated at least one additional time, in some cases several times, depending on the severity of the condition and the patient's overall health. If, for example, a patient is not deemed physically suitable for a full administration of botulinum toxin, or if a full administration is not desired for any reason, smaller doses on multiple occasions may prove to be efficacious.
  • an ordinarily skilled medical provider can determine the appropriate dose and frequency of administration(s) to achieve an optimum clinical result. That is, one of ordinary skill in medicine would be able to administer the appropriate amount of the toxin, for example botulinum toxin type A, at the appropriate time(s) to effectively treat the disorder.
  • the dose of the neurotoxin to be administered depends upon a variety of factors, including the severity of the disorder.
  • the dose of the toxins employed in accordance with this invention may be equivalent to the dose of BOTOX ® used in accordance with the present invention described herein.
  • a BOTOX ® e.g. botulinum toxin type A
  • a BOTOX ® e.g. botulinum toxin type A
  • BOTOX ® e.g. botulinum toxin type A
  • 0.1 U/kg to about 20 U/kg of BOTOX ® may be administered.
  • Use of from about 0.1 U/kg to about 30 U/kg of a BOTOX ® is within the scope of a method practiced according to the present disclosed invention.
  • about 0.1 U/kg to about 150 U/kg botulinum toxin, for example type A may be administered.
  • a method within the scope of the present invention can provide improved patient function.
  • the botulinum toxin composition can be administered at, for example, a dose of 10 to 1000 U of botulinum toxin per affected site, or a dose of 20 to 800 U of botulinum toxin per affected site, or a dose of 50 to 500 U of botulinum toxin per affected site, or a dose of 100 to 400 U of botulinum toxin per affected site, or a dose of 200 to 300 U of botulinum toxin per affected site, or the like.
  • the affected area can comprise multiple toxin administration sites.
  • Suitable active ingredients for inclusion in the composition include botulinum toxin type A, type B, type C, type D, type E, type F, and type G.
  • Other active ingredients can include, but are not limited to androgens, androstenediol and androisoxazole (for anabolic disorders), testosterone (hypogonadism, muscle wasting, male impotence, postmenopausal symptoms in women), dehydrotestosterdne (hypogdnadism, muscle wasting), dehydroepiandrostenone (muscle wasting, fat reduction, fitness); estrogens (postmenopausal symptoms, birth control), 17 betaestradiol, estradiol-3,17-diacetate, estradiol-3 -acetate, estradiol- 17-acetate, estradiol-3, 17-valerate, estradiol-3 -valerate, estradiol- 17-valerate, ethinyl estradiol, estrone
  • compositions of the invention can include agents that promote healing.
  • vasodilators such as nitroglycerin and glycerin mononitrate can be encapsulated in a phospholipid micelle and then combined with collagen and/or elastin in a lotion or cream formulation and applied to the skin.
  • the formulation of vasodilators in the composition enhances the rate of penetration as compared to administration via, for example, a skin patch.
  • Inclusion of hydrogen peroxide and/or a perfluorocarbon may further enhance oxygenation and healing.
  • composition can contain a single active ingredient or multiple active ingredients in the same composition. Various combinations of active ingredients are contemplated for inclusion in the composition.
  • Skin or mucus membrane penetration enhancers that promote the absorption of an active ingredient by the skin or mucus membrane can also be included in the composition.
  • skin or mucus membrane penetration enhancers include, but are not limited to, alcohols, such as short chain alcohols, long chain alcohols, or polyalcohols, amines and amides, such as urea, amino acids or their esters, amides, AZONE ® , derivatives of AZONE ® , pyrrolidones, or derivatives of pyrrolidones; terpenes and derivatives of terpenes; fatty acids and their esters; macrocyclic compounds; tensides; or sulfoxides such as, decylmethylsulfoxide.
  • Liposomes, transfersomes, lecithin vesicles, ethosomes, water surfactants, such as anionic, cationic, and nonionic surfactants, polyols, and essential oils can also function as skin or mucus membrane penetration enhancers.
  • Embodiments of the invention can comprise micelles, such as, for example, phospholipid micelles.
  • the phospholipid micelles may comprise sphingosine and cerebroside, for example, or the like.
  • the primary stabilizers may comprise elastin and collagen, for example, or the like.
  • the one or more skin penetration enhancers can be selected from the group that includes, for example, d-limonene, allantoin, fulvic acid, myrrh, hydroquinone glyquin, quillaja saponaria (QTS), acanthophyllum squarrusom (ATS), either singularly or in combination, or the like.
  • the botulinum toxin composition comprises:
  • composition may also be used for topical administration in a format whereby the composition penetrates the skin and transdermally denervates an underlying muscle.
  • the composition may include d-limonene to enhance penetration of the active ingredient through the dermal layer.
  • Limonene hasbeen found to be an effective skin penetration enhancer at 0.30%, enhancing skin permeation of botulinum toxin Type A approximately fourfold.
  • QTS Quillaja saponaria
  • ATS Acanthophyllum squarrusom
  • Allantoin may also be included in the composition. Allantoin acts as a skin protectant and a mild neutral skin penetration enhancer.
  • Eldopaque or hydroquinone glyquin may also be included as skin penetration enhancers.
  • the use of collagen in the composition, in combination with elastin and a mixture of sphingosine and cerebroside maintains the integrity of the complex without denaturing or fragmentation or detoxification.
  • botulinum toxin can be stabilized and the stabilized toxin can be successfully delivered transdermally to achieve similar results to those obtained by intramuscular injection of botulinum toxin.
  • compositions can be included to formulate the composition into other formats, such as a cream, lotion, spray, mask, gel, etc., that is suitable for topical administration. If formulated as a cream or a solution, the composition should contain the active ingredient in sufficiently concentrated quantities in order that the composition does not drip off the area of administation.
  • a preferred method for preparing a stabilized botulinum toxin composition for topical application below Briefly, equal amounts of collagen and elastin are solubilized in saline. In a separate flask, equal amounts of sphingosine and cerebroside are dissolved in alcohol. The alcohol is then removed. Botulinum toxin A is dissolved in saline and then added to the flask and the flask is swirled to coat the botulinum toxin protein with a phospholipid micelle coating. This solution is then added to the solution of collagen and elastin. This method can be used to prepare compositions containing other types of botulinum toxin. [0096] The composition may also be provided on a patch that is adhesively secured to the skin so that the active ingredient, such as botulinum toxin, can pass from the patch through the skin.
  • botulinum toxin type A can have an efficacy for up to 12 months (European J. Neurology 6 (Supp 4): SI 11-Sl 150: 1999), and in some circumstances for as long as 27 months (The Laryngoscope 109: 1344-1346: 1999).
  • the usual duration of an intramuscular injection of botulinum type A is typically about 3 to 4 months.
  • a 62 year old man complains of incontinence associated with sexual activity after a radical prostatectomy procedure. Based on a thorough examination, his doctor recommends a course of botulinum type A injections to the bladder wall.
  • the patient is injected with 200 U of botulinum type A divided among 30 injections into the bladder wall. Within 7 days of receiving the injections, the patient reports the elimination of the incontinence symptoms.
  • the bladder of the patient is instilled with a solution containing 1000 U of botulinum type A by filling the bladder with the solution, allowing the solution to remain within the bladder for 10 mintes, then draining the solution.
  • the patient reports the elimination of the incontinence symptoms.
  • Example 3 A 44 year old man complains of urinary incontinence at penetration after urogenital surgery. Based on a thorough examination, his doctor recommends a series of botulinum type A injections to the prostate.
  • the prostate of the patient is injected with 100 U of botulinum at 7-day intervals for 3 weeks. Following the course of injections, the patient's incontinence symptoms are reduced. Specifically, the volume of urine produced at climax is reduced.
  • a 24 year old woman complains of incontinence at penetration. She has previously been diagnosed with detrussor overactivity. Based on a thorough examination, her doctor recommends a series of botulinum type A injections to the bladder.
  • the patient is injected with 400 U of botulinum type B divided among 30 injections into the bladder wall. Within 7 days of receiving the injections, the patient reports the elimination of her incontinence symptoms.
  • a 61 year old woman complains of incontinence at climax. She has not been diagnosed with any urological abnormality. Based on a thorough examination, her doctor recommends administration of botulinum type A administration to the bladder wall.
  • the bladder of the patient is instilled with a solution containing 1000 U of botulinum type A by filling the bladder with the solution, allowing the solution to remain within the bladder for 10 mintes, then draining the solution.
  • the patient reports the elimination of the incontinence symptoms.
  • a 29 year old man complains of urinary incontinence associated with sexual activity after brachytherapy for prostate cancer. Based on a thorough examination, his doctor recommends a course of botulinum type A injections to the bladder wall.
  • the patient is injected with 200 U of botulinum type A divided among 30 injections into the bladder wall. Within 7 days of receiving the injections, the patient reports the elimination of the incontinence symptoms.
  • Example 7
  • a 55 year old man complains of urinary incontinence associated with sexual activity after radiation therapy for prostate cancer. Based on a thorough examination, his doctor recommends a course of botulinum type A injections to the bladder wall.
  • the patient is injected with 200 U of botulinum type A divided among 30 injections into the bladder wall. Within 7 days of receiving the injections, the patient reports the elimination of the incontinence symptoms.
  • a 39 year old man complains of urinary incontinence associated with sexual activity after brachytherapy for prostate cancer. Based on a thorough examination, his doctor recommends a treatment of SUDAFED ® .
  • the patient ingests 2 tablets of SUDAFED ® each day. Within 7 days of beginning the treatment, the patient reports the elimination of the incontinence symptoms.
  • a 55 year old man complains of urinary incontinence associated with sexual activity after radiation therapy for prostate cancer. Based on a thorough examination, his doctor recommends a course of botulinum type A injections to the bladder wall in combination with a SUDAFED ® regimen.
  • the patient is injected with 200 U of botulinum type A divided among 30 injections into the bladder wall.
  • the patient ingests 2 tablets of SUDAFED ® each day.
  • the patient reports the elimination of the incontinence symptoms.
  • a 55 year old woman complains of incontinence at climax. She has not been diagnosed with any urological abnormality. Based on a thorough examination, her doctor recommends botulinum type A administration to the bladder wall. Based on a thorough examination, her doctor recommends a course of botulinum type A injections to the bladder wall in combination with a SUDAFED ® regimen.
  • the patient is injected with 200 U of botulinum type A divided among 30 injections into the bladder wall.
  • the patient ingests 2 tablets of SUDAFED ® each day.
  • the patient reports the elimination of the incontinence symptoms.
  • the bladder of the patient is instilled with a solution containing 1000 U of botulinum type A by filling the bladder with the solution, allowing the solution to remain within the bladder for 10 mintes, then draining the solution.
  • the patient reports the elimination of the incontinence symptoms.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Epidemiology (AREA)
  • Urology & Nephrology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Immunology (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Reproductive Health (AREA)
  • Dermatology (AREA)
  • Gynecology & Obstetrics (AREA)
  • Endocrinology (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines Containing Plant Substances (AREA)

Abstract

L'invention concerne des compositions et des procédés pour le traitement de l'incontinence associée à l'activité sexuelle.
PCT/US2012/046720 2011-07-14 2012-07-13 Procédés pour le traitement de l'incontinence associée à l'activité sexuelle WO2013010100A1 (fr)

Priority Applications (9)

Application Number Priority Date Filing Date Title
EP12738350.3A EP2731620A1 (fr) 2011-07-14 2012-07-13 Procédés pour le traitement de l'incontinence associée à l'activité sexuelle
CA2841917A CA2841917A1 (fr) 2011-07-14 2012-07-13 Procedes pour le traitement de l'incontinence associee a l'activite sexuelle
RU2014103542/15A RU2578475C2 (ru) 2011-07-14 2012-07-13 Способы лечения недержания, связанного с половой активностью
JP2014520379A JP6092205B2 (ja) 2011-07-14 2012-07-13 性的行為に関連した失禁の治療方法
KR1020147003752A KR20140054055A (ko) 2011-07-14 2012-07-13 성행위와 관련된 실금의 치료방법
CN201280042815.5A CN103813802A (zh) 2011-07-14 2012-07-13 用于治疗与性活动相关的失禁的方法
AU2012280947A AU2012280947B2 (en) 2011-07-14 2012-07-13 Methods for treatment of incontinence associated with sexual activity
BR112014000634A BR112014000634A2 (pt) 2011-07-14 2012-07-13 métodos para tratamento de incontinência associada com atividade sexual
IN253DEN2014 IN2014DN00253A (fr) 2011-07-14 2014-01-13

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201161507686P 2011-07-14 2011-07-14
US61/507,686 2011-07-14

Publications (1)

Publication Number Publication Date
WO2013010100A1 true WO2013010100A1 (fr) 2013-01-17

Family

ID=46551933

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2012/046720 WO2013010100A1 (fr) 2011-07-14 2012-07-13 Procédés pour le traitement de l'incontinence associée à l'activité sexuelle

Country Status (11)

Country Link
US (3) US9144600B2 (fr)
EP (1) EP2731620A1 (fr)
JP (1) JP6092205B2 (fr)
KR (1) KR20140054055A (fr)
CN (1) CN103813802A (fr)
AU (1) AU2012280947B2 (fr)
BR (1) BR112014000634A2 (fr)
CA (1) CA2841917A1 (fr)
IN (1) IN2014DN00253A (fr)
RU (1) RU2578475C2 (fr)
WO (1) WO2013010100A1 (fr)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050191321A1 (en) * 2004-02-26 2005-09-01 Allergan, Inc. Methods for treating headache
US20100266638A1 (en) 2004-02-26 2010-10-21 Allergan, Inc. Headache treatment method
SG185338A1 (en) * 2007-10-23 2012-11-29 Allergan Inc Methods of treating urogenital-neurological disorders using modified clostridial toxins
US9144600B2 (en) 2011-07-14 2015-09-29 Allergan, Inc. Methods for treatment of incontinence associated with sexual activity
CN105848999A (zh) * 2013-12-26 2016-08-10 空中客车公司 具有机械臂的飞行器部件
US20150343036A1 (en) * 2014-05-28 2015-12-03 Allergan, Inc. Methods for reducing the occurrence or preventing formation of bladder calculi
US10026824B1 (en) 2017-01-18 2018-07-17 Globalfoundries Inc. Air-gap gate sidewall spacer and method
CN108573926B (zh) * 2017-03-09 2020-01-21 联华电子股份有限公司 半导体存储装置以及其制作方法
US12074471B2 (en) 2020-12-18 2024-08-27 Eaton Intelligent Power Limited Apparatus and methods for distribution of UPS-associated energy storage

Citations (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5437291A (en) 1993-08-26 1995-08-01 Univ Johns Hopkins Method for treating gastrointestinal muscle disorders and other smooth muscle dysfunction
US5670484A (en) 1994-05-09 1997-09-23 Binder; William J. Method for treatment of skin lesions associated with cutaneous cell-proliferative disorders
US5714468A (en) 1994-05-09 1998-02-03 Binder; William J. Method for reduction of migraine headache pain
US5766605A (en) 1994-04-15 1998-06-16 Mount Sinai School Of Medicine Of The City University Of New York Treatment of autonomic nerve dysfunction with botulinum toxin
WO1999003483A1 (fr) * 1997-07-15 1999-01-28 University Technology Corporation Therapie a base de neurotoxines pour le traitement de troubles urologiques et de troubles connexes
US6063768A (en) 1997-09-04 2000-05-16 First; Eric R. Application of botulinum toxin to the management of neurogenic inflammatory disorders
US6113915A (en) 1999-10-12 2000-09-05 Allergan Sales, Inc. Methods for treating pain
US6139845A (en) 1999-12-07 2000-10-31 Allergan Sales, Inc. Method for treating cancer with a neurotoxin
US6143306A (en) 2000-01-11 2000-11-07 Allergan Sales, Inc. Methods for treating pancreatic disorders
US6265379B1 (en) 1999-10-13 2001-07-24 Allergan Sales, Inc. Method for treating otic disorders
US6299893B1 (en) 2000-04-17 2001-10-09 Marvin Schwartz Method to reduce hair loss and stimulate hair regrowth
US6306423B1 (en) 2000-06-02 2001-10-23 Allergan Sales, Inc. Neurotoxin implant
US6306403B1 (en) 2000-06-14 2001-10-23 Allergan Sales, Inc. Method for treating parkinson's disease with a botulinum toxin
US6328977B1 (en) 2000-02-22 2001-12-11 Allergan Sales, Inc. Method for treating hyperparathyroidism
US6358513B1 (en) 2000-02-15 2002-03-19 Allergan Sales, Inc. Method for treating Hashimoto's thyroiditis
US6395277B1 (en) 1991-09-24 2002-05-28 Allergan Method and compositions for the treatment of cerebral palsy
US6423319B1 (en) 2000-10-04 2002-07-23 Allergan Sales, Inc. Methods for treating muscle injuries
US6458365B1 (en) 1993-12-28 2002-10-01 Allergan, Inc. Method for treating headache
US6464986B1 (en) 2000-04-14 2002-10-15 Allegan Sales, Inc. Method for treating pain by peripheral administration of a neurotoxin
US20040180065A1 (en) * 1997-07-15 2004-09-16 Schmidt Richard A. Use of neurotoxin therapy for treatment of urological-neurological disorders associated with prostate cancer
US7658933B2 (en) 2004-12-01 2010-02-09 Syntaxin, Ltd. Non-cytotoxic protein conjugates
US7659092B2 (en) 2004-12-01 2010-02-09 Syntaxin, Ltd. Fusion proteins
WO2010138384A2 (fr) * 2009-05-29 2010-12-02 Allergan, Inc. Procédés de traitement de troubles urogénitaux-neurologiques par le biais d'endopeptidases à reciblage d'interleukine

Family Cites Families (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9066943B2 (en) * 1997-07-15 2015-06-30 The Regents Of The University Of Colorado Use of botulinum toxin therapy for treatment of urological neurological conditions
US7838008B2 (en) * 1999-12-07 2010-11-23 Allergan, Inc. Methods for treating diverse cancers
US7838007B2 (en) * 1999-12-07 2010-11-23 Allergan, Inc. Methods for treating mammary gland disorders
WO2003030756A2 (fr) * 2001-10-12 2003-04-17 Ams Research Corporation Methode et instrument chirurgicaux
US20040266776A1 (en) * 2003-06-25 2004-12-30 Gil Daniel W. Methods of preventing and reducing the severity of stress-associated conditions
US20040067235A1 (en) * 2002-07-29 2004-04-08 Rajiv Doshi Methods for the use of neurotoxin in the treatment of urologic disorders
US8609113B2 (en) * 2003-10-29 2013-12-17 Allergan, Inc. Botulinum toxin treatments of depression
US8609112B2 (en) * 2003-10-29 2013-12-17 Allergan, Inc. Botulinum toxin treatments of depression
US20050191321A1 (en) * 2004-02-26 2005-09-01 Allergan, Inc. Methods for treating headache
US20100266638A1 (en) * 2004-02-26 2010-10-21 Allergan, Inc. Headache treatment method
US20090304747A1 (en) * 2006-05-16 2009-12-10 Mayo Foundation For Medical Education And Research Use of dmso and botulinum toxin therapy for urinary incontinence and related disorders
GB0610867D0 (en) 2006-06-01 2006-07-12 Syntaxin Ltd Treatment of pain
ES2520765T3 (es) * 2007-02-15 2014-11-11 Allergan, Inc. Uso de toxina botulínica para el tratamiento de hiperhidrosis
SG185338A1 (en) * 2007-10-23 2012-11-29 Allergan Inc Methods of treating urogenital-neurological disorders using modified clostridial toxins
US8470337B2 (en) * 2008-03-13 2013-06-25 Allergan, Inc. Therapeutic treatments using botulinum neurotoxin
US8940308B2 (en) * 2010-03-30 2015-01-27 Allergan, Inc. Methods for treating depression
US9144600B2 (en) * 2011-07-14 2015-09-29 Allergan, Inc. Methods for treatment of incontinence associated with sexual activity

Patent Citations (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6395277B1 (en) 1991-09-24 2002-05-28 Allergan Method and compositions for the treatment of cerebral palsy
US5437291A (en) 1993-08-26 1995-08-01 Univ Johns Hopkins Method for treating gastrointestinal muscle disorders and other smooth muscle dysfunction
US6458365B1 (en) 1993-12-28 2002-10-01 Allergan, Inc. Method for treating headache
US5766605A (en) 1994-04-15 1998-06-16 Mount Sinai School Of Medicine Of The City University Of New York Treatment of autonomic nerve dysfunction with botulinum toxin
US5670484A (en) 1994-05-09 1997-09-23 Binder; William J. Method for treatment of skin lesions associated with cutaneous cell-proliferative disorders
US5714468A (en) 1994-05-09 1998-02-03 Binder; William J. Method for reduction of migraine headache pain
WO1999003483A1 (fr) * 1997-07-15 1999-01-28 University Technology Corporation Therapie a base de neurotoxines pour le traitement de troubles urologiques et de troubles connexes
US6365164B1 (en) 1997-07-15 2002-04-02 University Technology Corporation Use of neurotoxin therapy for treatment of urologic and related disorders
US20040180065A1 (en) * 1997-07-15 2004-09-16 Schmidt Richard A. Use of neurotoxin therapy for treatment of urological-neurological disorders associated with prostate cancer
US6063768A (en) 1997-09-04 2000-05-16 First; Eric R. Application of botulinum toxin to the management of neurogenic inflammatory disorders
US6113915A (en) 1999-10-12 2000-09-05 Allergan Sales, Inc. Methods for treating pain
US6265379B1 (en) 1999-10-13 2001-07-24 Allergan Sales, Inc. Method for treating otic disorders
US6139845A (en) 1999-12-07 2000-10-31 Allergan Sales, Inc. Method for treating cancer with a neurotoxin
US6143306A (en) 2000-01-11 2000-11-07 Allergan Sales, Inc. Methods for treating pancreatic disorders
US6358513B1 (en) 2000-02-15 2002-03-19 Allergan Sales, Inc. Method for treating Hashimoto's thyroiditis
US6328977B1 (en) 2000-02-22 2001-12-11 Allergan Sales, Inc. Method for treating hyperparathyroidism
US6464986B1 (en) 2000-04-14 2002-10-15 Allegan Sales, Inc. Method for treating pain by peripheral administration of a neurotoxin
US6299893B1 (en) 2000-04-17 2001-10-09 Marvin Schwartz Method to reduce hair loss and stimulate hair regrowth
US6312708B1 (en) 2000-06-02 2001-11-06 Allergan Sales, Inc. Botulinum toxin implant
US6306423B1 (en) 2000-06-02 2001-10-23 Allergan Sales, Inc. Neurotoxin implant
US6306403B1 (en) 2000-06-14 2001-10-23 Allergan Sales, Inc. Method for treating parkinson's disease with a botulinum toxin
US6423319B1 (en) 2000-10-04 2002-07-23 Allergan Sales, Inc. Methods for treating muscle injuries
US7658933B2 (en) 2004-12-01 2010-02-09 Syntaxin, Ltd. Non-cytotoxic protein conjugates
US7659092B2 (en) 2004-12-01 2010-02-09 Syntaxin, Ltd. Fusion proteins
WO2010138384A2 (fr) * 2009-05-29 2010-12-02 Allergan, Inc. Procédés de traitement de troubles urogénitaux-neurologiques par le biais d'endopeptidases à reciblage d'interleukine

Non-Patent Citations (13)

* Cited by examiner, † Cited by third party
Title
AARON D MARTIN ET AL: "Incontinence After Radical Prostatectomy: A Patient Centered Analysis and Implications for Preoperative Counseling", JOURNAL OF UROLOGY, vol. 186, no. 1, July 2011 (2011-07-01), pages 204 - 208, XP028378680, ISSN: 0022-5347, [retrieved on 20110301], DOI: 10.1016/J.JURO.2011.02.2698 *
ABOUASSALY R; LANE B; LAKIN M; KLEIN E; GILL I: "Ejaculatory incontinence after radical prostatectomy: a review of 26 cases.", PROGRAM AND ABSTRACTS OF THE SEXUAL MEDICINE SOCIETY OF NORTH AMERICA FALL MEETING, 17 November 2005 (2005-11-17)
BY WEIGAND ET AL., NAUNYN-SCHMIEDEBERG'S ARCH. PHARMACOL., vol. 292, 1976, pages 161 - 165
EUROPEAN J. NEUROLOGY, vol. 6, no. 4, 1999, pages S 111 - S 1150
FUNG L. K. ET AL.: "Pharmacokinetics of Interstitial Delivery of Carmustine 4-Hydroperoxycyclophosphamide and Paclitaxel From a Biodegradable Polymer Implant in the Monkey Brain", CANCER RESEARCH, vol. 58, 1998, pages 672 - 684
HABERMANN, NAUNYN-SCHMIEDEBERG'S ARCH. PHARMACOL., vol. 281, 1974, pages 47 - 56
KATHLEEN DOHENY: "Sex, exercise and stress incontinence", 15 May 2010 (2010-05-15), XP002684126, Retrieved from the Internet <URL:http://www.webmd.boots.com/sex-relationships/guide/sex-workouts-stress-incontinence?page=3> [retrieved on 20120926] *
MARJAMA-JYONS, J. ET AL.: "Tremor-Predominant Parkinson's Disease", DRUGS & AGING, vol. 16, no. 4, 2000, pages 273 - 278
MITCHELL SARAH A ET AL: "Post-prostatectomy incontinence during sexual activity: a single center prevalence study.", September 2011, THE JOURNAL OF UROLOGY SEP 2011 LNKD- PUBMED:21791358, VOL. 186, NR. 3, PAGE(S) 982 - 985, ISSN: 1527-3792, XP002684125 *
RISS P ET AL: "Quality of life and urinary incontinence in women", MATURITAS, ELSEVIER SCIENCE PUBLISHERS IRELAND LTD, IR, vol. 68, no. 2, 1 February 2011 (2011-02-01), pages 137 - 142, XP027596072, ISSN: 0378-5122, [retrieved on 20110111], DOI: 10.1016/J.MATURITAS.2010.11.006 *
See also references of EP2731620A1
SINHA ET AL: "Applications of Botulinum toxin in urogynaecology", EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVEBIOLOGY, EXCERPTA MEDICA, AMSTERDAM, NL, vol. 133, no. 1, 1 July 2007 (2007-07-01), pages 4 - 11, XP022131061, ISSN: 0301-2115, DOI: 10.1016/J.EJOGRB.2006.12.014 *
THE LARYNGOSCOPE, vol. 109, 1999, pages 1344 - 1346

Also Published As

Publication number Publication date
BR112014000634A2 (pt) 2017-02-14
JP6092205B2 (ja) 2017-03-08
EP2731620A1 (fr) 2014-05-21
JP2014520861A (ja) 2014-08-25
AU2012280947B2 (en) 2016-04-07
US9480732B2 (en) 2016-11-01
US10034923B2 (en) 2018-07-31
AU2012280947A1 (en) 2014-01-30
IN2014DN00253A (fr) 2015-06-05
RU2014103542A (ru) 2015-08-20
KR20140054055A (ko) 2014-05-08
CA2841917A1 (fr) 2013-01-17
RU2578475C2 (ru) 2016-03-27
CN103813802A (zh) 2014-05-21
US20130034587A1 (en) 2013-02-07
US20160008441A1 (en) 2016-01-14
US9144600B2 (en) 2015-09-29
US20170042984A1 (en) 2017-02-16

Similar Documents

Publication Publication Date Title
US10034923B2 (en) Methods for treatment of incontinence associated with sexual activity
US10420823B2 (en) Method for treating premature ejaculation with a botulinum neurotoxin
AU2012283968B2 (en) Botulinum toxins for use in a method for treatment of adipose deposits
US20070224184A1 (en) Method for treating cellulite
JP2011037866A (ja) 経皮ボツリヌス毒素組成物

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 12738350

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 2014520379

Country of ref document: JP

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: 2841917

Country of ref document: CA

NENP Non-entry into the national phase

Ref country code: DE

REEP Request for entry into the european phase

Ref document number: 2012738350

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 2012738350

Country of ref document: EP

ENP Entry into the national phase

Ref document number: 2012280947

Country of ref document: AU

Date of ref document: 20120713

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: 20147003752

Country of ref document: KR

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: 2014103542

Country of ref document: RU

Kind code of ref document: A

REG Reference to national code

Ref country code: BR

Ref legal event code: B01A

Ref document number: 112014000634

Country of ref document: BR

ENP Entry into the national phase

Ref document number: 112014000634

Country of ref document: BR

Kind code of ref document: A2

Effective date: 20140110